Provider Demographics
NPI:1649921453
Name:KRAVITZ, DANA LEIGH (LICSW)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:LEIGH
Last Name:KRAVITZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 L ST NW APT 417
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2596
Mailing Address - Country:US
Mailing Address - Phone:301-787-2220
Mailing Address - Fax:
Practice Address - Street 1:425 L ST NW APT 417
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-2596
Practice Address - Country:US
Practice Address - Phone:301-787-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC200014591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical